HADASSAH YAHRZEIT IN ISRAELPlease print carefully in English, and where requested, in English letters(transliteration) for Hebrew names. This information, which will be transliter-ated into Hebrew in Israel, is required for entry in the Hadassah Yahrzeitmemorial display and for the recitation of the Kaddish prayer.

DONOR INFORMATION

Yahrzeit Notice ❏ Yes ❏ No Certificate ❏ Yes ❏ No

Name

Address

City/State/Zip

Telephone

Is the donor a member of Hadassah? ❏ Yes ❏ No

Region/Chapter/Group

Name of Departed (English)

Name of Departed (Hebrew)

Father’s Name (English)

Father’s Name (Hebrew)

Mother’s Name (English)

Mother’s Name (Hebrew)

If Kohan or Levi, please indicate which

Date and year of death

Time of death

SEND A SECOND YAHRZEIT NOTICE TO:

Name

Address

City/State/Zip

One certificate and two notices are the standard for each Yahrzeit

PAYMENT INFORMATION

❏ Enclosed is my check (payable to Hadassah Medical Relief Association, Inc.)

Please charge my: ❏ Visa ❏ Mastercard ❏ American Express

Account Number Exp. Date

Name as it appears on card (please print)

Signature

I learned of the Hadassah Perpetual Yahrzeit Program from:

❏ Hadassah Magazine ❏ Newspaper ❏ Local Unit

❏before sundown ❏

after sundown

Hadassah has made it possible to have Kaddishrecited for your loved ones at the beautifulFannie and Maxwell Abbell Synagogue on thepremises of the Hadassah-Hebrew UniversityMedical Center at Ein Kerem, Jerusalem. Aone-time donation of $1,000 ensures thedesignated Yahrzeit date will be observed inperpetuity, and that the Kaddish prayer willecho within sanctified walls, beneath themagnificent stained glass windows by MarcChagall. Your loved ones will be remem-bered in Israel at Hadassah Hospital,where birth and renewal help us toassuage our grief and pay tribute to thefuture while remembering the past.

Donations support Hadassah MedicalOrganization activities, including healing,teaching and research. In this way, donorscan transform loss into life-affirmingmitzvot that reach far and wide, benefittingcountless people the world over.

Each year, prior to the Yahrzeit date, you willreceive a notice from Israel acknowledgingthe upcoming observance. On that date,your loved one’s name will be memorializedduring the mincha (afternoon) service heldat the Abbell Synagogue.

In addition, a stunning Hadassah Yahrzeitcertificate featuring a replica of a Chagallwindow will be issued to the individualestablishing the memorial.